Suspected Chemical Coping in a Terminal Home Care Case: Reducing Anxiety through the Appropriate Use of Opioids with Multi-disciplinary Cooperation and Pharmaceutical Intervention

Abstract

Recently, the necessity and demand for home medical care have increased. Moreover, patients and their family members often prefer that terminal patients die at home. Here, the case of a female patient with suspected chemical coping during terminal care at home is described. She suffered from mental distress due to anxiety and insomnia; therefore, she frequently consumed oxycodone hydrochloride at night. To avoid serious adverse reactions, discussions and correspondence were conducted through multi-disciplinary cooperative information sharing and pharmaceutical interventions. “Chemical coping” was deemed to be the stage before the development of abuse and dependence. In most cases, chemical coping is overlooked because it is rarely reported. When receiving home medical care, patients who feel anxious may develop chemical coping, as medical staff are not always available, unlike in hospital environments. Therefore, throughout terminal care at home, it is crucial to provide the patient and their family with professional guidance and cooperation to avoid the risk of the patient developing chemical coping behaviors.